Bradley D Fanestil, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR.0031874 Issued in CO

Practice address

4801 Riverbend Rd Ste 120B
Boulder, CO 80301-2613

Phone

(303) 415-8615

Fax

(303) 293-0628

NPI assigned

Feb 1, 2007

Last updated

May 10, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

65.53 of 100Reported as group

Quality

23.06

Promoting interoperability

79

Improvement activities

40

Cost

79.53

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boulder Community Health

  dba Community Medical Associates of BCH

  • Medical Specialty Clinic/Center
  • Boulder, CO
  • NPI 1407685498
  NPD (past)
• Sound Hospitalists of Centura, PC

  • Hospitalist Physician
  • Parker, CO
  • NPI 1497057269

  Internal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1023156254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-4250",
            "fax_number": "303-440-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 RIVERBEND RD STE 120B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012613",
            "telephone_number": "303-415-8615",
            "fax_number": "303-293-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANESTIL",
        "first_name": "BRADLEY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0031874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family First Vision Care Colorado LLC
• Family Hearing Centers
• Family Home Health LLC
• Family Home Health LLC
• Family Solutions Center LLC
• Ashley Fanning, FNP
• Alec Farbman
• Stephanie Faren, RN
• Dorothy Ellen Faris, MD
• Sarah Farley

• Internal Medicine Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.